PDL2 compounds

ABSTRACT

The present invention relates to a peptide compound of PDL2 selected from a peptide fragment, a functional homologue, and a functional analogue, as well as to a nucleic acid, such as DNA or RNA, encoding the peptide compound, a vector, such as a virus vector, and a host cell, such as mammalian cell, comprising the vector. The peptide compound, nucleic acid, vector and host cell of the present invention are in particular, useful for the treatment or prevention of a cancer characterized by expression of PDL2.

RELATED APPLICATIONS

This application is divisional of U.S. patent application Ser. No.16/344,445, filed Apr. 24, 2019, which is a 35 U.S.C. 371 national stagefiling of International Application No. PCT/EP2017/076179, filed Oct.13, 2017, which claims priority to European Patent Application No.16195949.9, filed Oct. 27, 2016, each of which are incorporated hereinby reference in their entirety.

SEQUENCE LISTING

The instant application contains a Sequence Listing which has beensubmitted electronically in ASCII format and is hereby incorporated byreference in its entirety. Said ASCII copy, created on Jun. 25, 2020, isnamed JKJ-067USDV_Sequence_Listing.txt and is 10,666 bytes in size.

TECHNICAL FIELD

The present invention relates to novel peptide compounds, such asfragments of PDL2, as well as compositions, uses, and kit-of-partscomprising these peptide compounds. Furthermore, the invention concernsnucleic acids, vectors, and host cells expressing said peptidecompounds, for use in a method for treatment or prevention of a cancer,either alone or when administered simultaneously or sequentially with anadditional cancer therapy.

BACKGROUND ART

Molecules of the B7-CD28 family play an important role in T-cellactivation and tolerance. These pathways are not only responsible forproviding positive costimulatory signals to sustain T-cell activity, butalso contribute inhibitory signals that modulate the magnitude of T-cellresponses. Inhibitory molecules of the B7/CD28 family play a key role inthe induction of immune tolerance in the tumor microenvironment. Theprogrammed death-1 receptor (PD-1, CD279) with its ligands PD-L1 (CD274,B7-H1) and PD-L2 (CD273, B7-DC) constitutes one such inhibitory pathway.The relevance of the PD-1/PD-L1 pathway in cancer has been extensivelystudied and therapeutic approaches targeting PD-1 (e.g. nivolumab orpembrolizumab) and PD-L1 (e.g. avelumab or atezolizumab) have beendeveloped and are already approved in several different indications ofcancer. However, PD-L2 has not received as much attention and its rolein modulating tumor immunity is less clear. It is known that PD-L2 is aninhibitory molecule, expressed not only by antigen-presenting cells, butalso by other immune cells and nonimmune cells in an inducible manner,mainly through Th2-associated cytokines. Hence, the patterns ofexpression of PD-L1 and PD-L2 are quite distinct. PD-L1 isconstitutively expressed by a wide variety of immune cells and nonimmunecells and most normal tissue cells seem to be able to upregulate PD-L1.PD-L2 expression was initially thought to be restricted toantigen-presenting cells such as macrophages and dendritic cells (DCs).In recent years however, several groups have shown that PD-L2 expressioncan be induced on a wide variety of other immune cells and nonimmunecells depending on microenvironmental stimuli. Importantly, PD-L2expression has been reported in patients with cancer. Moreover, PD-L2may be expressed within human tumours in the absence of PD-L1. Thiscould impact the understanding of the effectiveness of differenttargeted therapies to anti-PD-1 therapy even in the absence of PD-L1expression. Hence, PD-L2 expression has been described in several tumortypes, including renal cell carcinoma, bladder carcinoma, melanoma,non-small-cell lung cancer (NSCLC), head and neck squamous carcinoma(HNSC), triple-negative breast cancer (TNBC), and gastric carcinoma.PD-L2 may be expressed in individual tumor samples even in the absenceof PD-L1(www.esmo.org/Conferences/Past-Conferences/European-Cancer-Congress-2015/News/Novel-Assay-Developed-to-Determine-PD-L2-Expression-in-Tumour-Samples).

Ohigashi et al. investigated the expression of PD-L1 and PD-L2 in humanesophageal cancer to determine their clinical significance in patients'prognosis after surgery. Using RT-qPCR and immunohistochemistry, theauthors showed that both PD-L1 and PD-L2 are expressed in frozen tissuesamples of esophageal cancer patients and PD-L2-positive patients had apoorer prognosis than the negative patients, as was the case for PD-L1.

Interestingly, there was a significant inverse correlation between PD-L2expression and CD8 TILs but not CD4 TILs. In a retrospective studyinvolving 51 patients with pancreatic cancer, 27% of the analyzed tumorsexpressed PD-L2 versus 39% expressing PD-L1.

It is also important to note here that perhaps not only PD-L2 expressionby the tumor cells themselves, but rather by stromal cells is ofimportance. Nazareth and colleagues found constitutively high PD-L1 and2 expressions in fibroblasts that were cultured from humannon-small-cell lung cancers. This expression appeared to be functional,since in vitro blocking studies demonstrated that the fibroblastsinhibited IFNγ-production by autologous T cells in a PD-L1- and2-dependent manner. For this reason, future studies should not onlyfocus on PD-L expression by tumor cells only, but also by the tumorstroma.

SUMMARY OF THE INVENTION

The present inventor has identified new immunogenic epitopes fromextended PDL2 (human PDL2 including a signal sequence identified by SEQID NO 1 herein, reference NCBI accession Q9BQ51, version Q9BQ51.2).Several PD-L2 derived peptides were selected based on binding affinityto the tissue type HLA-A2, of these a smaller selection was furtheranalyzed by ELISPOT, since at least part of the sequences of thesepeptides are either in the signal peptide part of the PD-L2 sequence orin the transmembrane domain of the PD-L2 protein sequence. The presentinventor scrutinized peripheral blood mononuclear cells (PBMC) from ninecancer patients for the presence of specific T-cell responses againstPD-L2-derived peptide using the IFN ELISPOT secretion assay. Strongresponses were detected against some peptides and in particular, theresponse against one peptide was in addition readily detectable inhealthy individuals (HD).

In one aspect, the present invention concerns a peptide fragment of ahuman PDL2 protein of SEQ ID NO: 1, which fragment is up to 100 aminoacids in length and wherein the peptide fragment comprises or consistsof a consecutive sequence in a range from 8 to 100 amino acids of SEQ IDNO: 1; or a pharmaceutically acceptable salt thereof.

The present invention also concerns a peptide fragment of a human PDL2protein of SEQ ID NO: 1, which fragment is up to 100 amino acids inlength and wherein the peptide fragment consists of a consecutivesequence in a range from 8 to 100 amino acids of SEQ ID NO: 1; or apharmaceutically acceptable salt thereof.

In an embodiment the peptide fragment is up to 60 amino acids in length,such as up to 50 amino acids, up to 40 amino acids, or up to 30 aminoacids in length. The corresponding upper range in the consecutivesequence is accordingly, 60, 50, 40 or 30 amino acids of SEQ ID NO: 1.

In a further embodiment the peptide is up to 21, 22, 23, 24, 25, 26, 27,28, 29, or 30 amino acids in length.

In another embodiment the peptide fragment comprises or consists of aconsecutive sequence in the range from 10 to 100 amino acids, such asfrom 10-17 amino acids, 20 to 30 amino acids, 30 to 40 amino acids, orfrom 40 to 50 amino acids.

In a further embodiment the peptide fragment consists of a consecutivesequence in the range from 10 to 100 amino acids, such as from 10-17amino acids, 20 to 30 amino acids, 30 to 40 amino acids, or from 40 to50 amino acids. Typically from 10-17 amino acids or from 20 to 100 aminoacids.

In another embodiment the peptide fragment does not comprise amino acid1-3 of SEQ ID NO 1, that is MIF. Studies of PDL2 did not reveal anysignificant effect of these 3 amino acids, and they do not contribute toactivation of T-cells.

In a further embodiment the consecutive sequence comprises one or moresequences selected from any one of SEQ ID NO 2-12, such as any one ofSEQ ID NO 2, 4, 11 and 12.

In one embodiment the consecutive sequence comprises both SEQ ID NO 2and SEQ ID NO 4. For instance, the peptide fragment SEQ ID NO: 12comprises both SEQ ID NO 2 and SEQ ID NO 4.

In a further embodiment the consecutive sequence comprises a sequenceselected from SEQ ID NO 11, wherein the peptide fragment is up to 21,22, 23, 24, 25, 26, 27, 28, 29, or 30 amino acids in length. Preferably,the consecutive sequence consist of SEQ ID NO 11.

In a still further embodiment the consecutive sequence comprises asequence selected from SEQ ID NO 12, wherein the peptide fragment is upto 25, 26, 27, 28, 29, or 30 amino acids in length.

In a further embodiment the consecutive sequence comprises a sequenceselected from SEQ ID NO 4, wherein the peptide fragment is up to 10, 11,12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29,or 30 amino acids in length.

In a still further embodiment the consecutive sequence comprises asequence selected from SEQ ID NO 2, wherein the peptide fragment is upto 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25,26, 27, 28, 29, or 30 amino acids in length.

In a further embodiment the peptide fragment is capable of activatingT-cells, such as CD4 and CD8 T-cells. Typically, the activation isdetermined by an ELISPOT assay, such as the ELISPOT assay describedherein.

The C terminal amino acid may be in the form of the acid or the amide,both are contemplated as individual embodiments of the peptide fragmentof the present invention.

Typically, the peptide fragment is an isolated, immunogenic peptidefragment.

In a further aspect the present invention relates to a compositioncomprising the peptide fragment of the present invention, optionallytogether with a pharmaceutically acceptable additive, such as carrier oradjuvant.

When the adjuvant is present, such adjuvant is preferably selected fromthe group consisting of bacterial DNA based adjuvants, oil/surfactantbased adjuvants, viral dsRNA based adjuvants, imidazochinilines, aMontanide ISA adjuvant.

In a further aspect the present invention relates to a peptide fragmentof the present invention for use in the treatment of cancer, such ascancer characterized by expression of PDL2.

In a still further aspect the present invention relates to a method oftreating or preventing cancer in a patient, the method comprisingadministering to the cancer patient an effective amount of the peptidefragment of the present invention. In an embodiment the method furthercomprises the simultaneous or sequential administration of an additionalcancer therapy, such as a cytokine therapy, a T-cell therapy, an NKtherapy, an immune system checkpoint inhibitor, chemotherapy,radiotherapy, immunostimulating substances, gene therapy, antibodies anddendritic cells. In a further embodiment the additional cancer therapyis selected from one or more of Actimide, Azacitidine, Azathioprine,Bleomycin, Carboplatin, Capecitabine, Cisplatin, Chlorambucil,Cyclophosphamide, Cytarabine, Daunorubicin, Docetaxel, Doxifluridine,Doxorubicin, Epirubicin, Etoposide, Fludarabine, Fluorouracil,Gemcitabine, Hydroxyurea, Idarubicin, Irinotecan, Lenalidomide,Leucovorin, Mechlorethamine, Melphalan, Mercaptopurine, Methotrexate,Mitoxantrone, Nivolumab, Oxaliplatin, Paclitaxel, Pembrolizumab,Pemetrexed, Revlimid, Temozolomide, Teniposide, Thioguanine, Valrubicin,Vinblastine, Vincristine, Vindesine and Vinorelbine.

In a further aspect, the present invention concerns a nucleic acid, suchas DNA or RNA, encoding the peptide fragment of the present invention.

In a still further aspect, the present invention concerns a vector, suchvirus vector, comprising the nucleic acid of the present invention.

In a further aspect, the present invention concerns a host cell, such asmammalian cell, comprising the vector of the present invention.

In a further aspect, the present invention relates to a kit-of-partscomprising:

-   -   a) the composition of the present invention, and    -   b) a composition comprising at least one second active        ingredient, selected from an immunostimulating compound, such as        an interleukin, e.g. IL-2 and or IL-21, an anti-cancer agent,        such as a chemotherapeutic agent, e.g. Actimide, Azacitidine,        Azathioprine, Bleomycin, Carboplatin, Capecitabine, Cisplatin,        Chlorambucil, Cyclophosphamide, Cytarabine, Daunorubicin,        Docetaxel, Doxifluridine, Doxorubicin, Epirubicin, Etoposide,        Fludarabine, Fluorouracil, Gemcitabine, Hydroxyurea, Idarubicin,        Irinotecan, Lenalidomide, Leucovorin, Mechlorethamine,        Melphalan, Mercaptopurine, Methotrexate, Mitoxantrone,        nivolumab, Oxaliplatin, Paclitaxel, pembrolizumab, Pemetrexed,        Revlimid, Temozolomide, Teniposide, Thioguanine, Valrubicin,        Vinblastine, Vincristine, Vindesine and Vinorelbine.

In a further embodiment, the provided compositions are to beadministered simultaneously or sequentially.

In a further aspect, the present invention relates to a method oftreating a clinical condition characterized by expression of PDL2 (SEQID NO 1), the method comprising administering to an individual sufferingfrom said clinical condition an effective amount of the peptide compoundor fragment of the present invention or the nucleic acid of the presentinvention or vector of the present invention or host cell of the presentinvention.

In a still further aspect, the present invention relates to a method oftreating or preventing cancer in a patient, the method comprisingadministering to the cancer patient an effective amount of the peptidecompound or fragment of the present invention or the nucleic acid of thepresent invention or vector of the present invention or host cell of thepresent invention.

In a further aspect, the present invention relates to use of the peptidecompound or fragment of the present invention or the nucleic acid of thepresent invention or vector of the present invention or host cell of thepresent invention for the manufacture of a medicament, such as ancomposition or vaccine, for the treatment or prevention of a cancer,such as cancer characterized by expression of PDL2.

In a still further aspect, the present invention relates to the peptidefragment of the present invention or the nucleic acid of the presentinvention or vector of the present invention or host cell of the presentinvention, for use in a method for treatment or prevention of a cancer,when administered simultaneously or sequentially with an additionalcancer therapy, such as a cytokine therapy, a T-cell therapy, an NKtherapy, an immune system checkpoint inhibitor, chemotherapy,radiotherapy, immunostimulating substances, gene therapy, antibodies anddendritic cells.

In an embodiment, the additional cancer therapy is selected fromcheckpoint blocking antibodies.

In a further embodiment the additional cancer therapy is selected fromone or more of Actimide, Azacitidine, Azathioprine, Bleomycin,Carboplatin, Capecitabine, Cisplatin, Chlorambucil, Cyclophosphamide,Cytarabine, Daunorubicin, Docetaxel, Doxifluridine, Doxorubicin,Epirubicin, Etoposide, Fludarabine, Fluorouracil, Gemcitabine,Hydroxyurea, Idarubicin, Irinotecan, Lenalidomide, Leucovorin,Mechlorethamine, Melphalan, Mercaptopurine, Methotrexate, Mitoxantrone,Nivolumab, Oxaliplatin, Paclitaxel, Pembrolizumab, Pemetrexed, Revlimid,Temozolomide, Teniposide, Thioguanine, Valrubicin, Vinblastine,Vincristine, Vindesine and Vinorelbine.

Further aspect are:

-   1. A peptide compound of PDL2 selected from:    -   a) a peptide fragment of SEQ ID NO 1 consisting of a consecutive        sequence of from 8 to 272 amino acids,    -   b) a functional homologue having at least 70%, 80%, 90%, or 95%        identity to SEQ ID NO 1 or the peptide fragment of a), and    -   c) a functional analogue wherein at least one amino acid has        been deleted, inserted and/or substituted in SEQ ID NO 1 or the        peptide fragment of a),    -   and wherein the C-terminal amino acid of any one of a), b) or c)        also comprises the amide;    -   or a pharmaceutically acceptable salt thereof.-   2. The peptide compound of aspect 1 selected from a) a peptide    fragment of SEQ ID NO 1 consisting of a consecutive sequence of from    8 to 272 amino acids, wherein the C-terminal amino acid also    comprises the amide;    -   or a pharmaceutically acceptable salt thereof.-   3. The peptide compound of aspect 2 wherein the peptide fragment    consists of a consecutive sequence in the range of from 8 to 250    amino acids, 8 to 200 amino acids, 8 to 150 amino acids, 8 to 120    amino acids, e.g. 10 to 100 amino acids, 20 to 80 amino acids, 30 to    60 amino acids, 40 to 50 amino acids.-   4. The peptide compound of any one of aspects 2-3 wherein the    peptide fragment of SEQ ID NO 1 is selected from the group    consisting of PDL2(1-25), PDL2(1-50), PDL2(200-273), and    PDL2(210-250).-   5. The peptide compound of any one of aspects 2-4 wherein the    consecutive sequence comprises one or more sequences selected from    any one of SEQ ID NO 2-12, such as one sequence selected from SEQ ID    NO 7 or two sequence selected from SEQ ID NO 2 and 4.-   6. The peptide compound of any one of aspects 1-5 wherein the    peptide fragment under a), the functional homologue under b), or the    functional analogue under c) is capable of activating T-cells, such    as CD4 and CD8 T-cells.-   7. The peptide compound of aspect 6 wherein the activation is    determined by the ELISPOT assay described herein.-   8. A nucleic acid, such as DNA or RNA, encoding the peptide compound    of any one of the preceding aspects.-   9. A vector, such virus vector, comprising the nucleic acid of    aspect 8.-   10. A host cell, such as mammalian cell, comprising the vector of    aspect 9.-   11. A composition comprising the peptide compound of any one of    aspects 1-7 or the nucleic acid of aspect 8 or the vector of aspect    9 or the host cell of aspect 10, optionally together with a    pharmaceutically acceptable additive, such as carrier or adjuvant.-   12. An immunotherapeutic composition comprising    -   a) the peptide compound of any one of aspects 1-7 or the nucleic        acid of aspect 8 or the vector of aspect 9 or the host cell of        aspect 10; and    -   b) an adjuvant;    -   for use as a medicament.-   13. The immunotherapeutic composition of aspect 12 for use in a    method for treatment or prevention of a disease, disorder or    condition selected from cancer, such as a tumor forming cancer    disease.-   14. The immunotherapeutic composition of any one of aspects 11-13    wherein the adjuvant is selected from the group consisting of    bacterial DNA based adjuvants, oil/surfactant based adjuvants, viral    dsRNA based adjuvants, imidazochinilines, a Montanide ISA adjuvant.-   15. A kit-of-parts comprising;    -   a) the immunotherapeutic composition of any one of aspects        12-14, and    -   b) a composition comprising at least one second active        ingredient, selected from an immunostimulating compound, such as        an interleukin, e.g. IL-2 and or IL-21, an anti-cancer agent,        such as a chemotherapeutic agent, e.g. Actimide, Azacitidine,        Azathioprine, Bleomycin, Carboplatin, Capecitabine, Cisplatin,        Chlorambucil, Cyclophosphamide, Cytarabine, Daunorubicin,        Docetaxel, Doxifluridine, Doxorubicin, Epirubicin, Etoposide,        Fludarabine, Fluorouracil, Gemcitabine, Hydroxyurea, Idarubicin,        Irinotecan, Lenalidomide, Leucovorin, Mechlorethamine,        Melphalan, Mercaptopurine, Methotrexate, Mitoxantrone,        nivolumab, Oxaliplatin, Paclitaxel, pembrolizumab, Pemetrexed,        Revlimid, Temozolomide, Teniposide, Thioguanine, Valrubicin,        Vinblastine, Vincristine, Vindesine and Vinorelbine.-   16. The kits-of-parts according to aspect 15, where the provided    compositions are to be administered simultaneously or sequentially.-   17. A method of treating a clinical condition characterized by    expression of PDL2 of SEQ ID NO 1, the method comprising    administering to an individual suffering from said clinical    condition an effective amount of the peptide compound of any one of    aspects 1-7 or the nucleic acid of aspect 8 or vector of aspect 9 or    host cell of aspect 10.-   18. A method of treating or preventing cancer in a patient, the    method comprising administering to the cancer patient an effective    amount of the peptide compound of any one of aspects 1-7 or the    nucleic acid of aspect 8 or vector of aspect 9 or host cell of    aspect 10.-   19. Use of the peptide compound of any one of aspects 1-7 or the    nucleic acid of aspect 8 or vector of aspect 9 or host cell of    aspect 10 for the manufacture of a medicament, such as an    immunotherapeutic composition or vaccine, for the treatment or    prevention of a cancer characterized by expression of PDL2.-   20. A peptide compound of any one of aspects 1-7 or the nucleic acid    of aspect 8 or vector of aspect 9 or host cell of aspect 10, for use    in a method for treatment or prevention of a cancer, when    administered simultaneously or sequentially with an additional    cancer therapy, such as a cytokine therapy, a T-cell therapy, an NK    therapy, an immune system checkpoint inhibitor, chemotherapy,    radiotherapy, immunostimulating substances, gene therapy,    anti-bodies and dendritic cells.-   21. The peptide fragment, nucleic acid, vector or host cell of    aspect 20 wherein the checkpoint blocking antibodies are selected    from Actimide, Azacitidine, Azathioprine, Bleomycin, Carboplatin,    Capecitabine, Cisplatin, Chlorambucil, Cyclophosphamide, Cytarabine,    Daunorubicin, Docetaxel, Doxifluridine, Doxorubicin, Epirubicin,    Etoposide, Fludarabine, Fluorouracil, Gemcitabine, Hydroxyurea,    Idarubicin, Irinotecan, Lenalidomide, Leucovorin, Mechlorethamine,    Melphalan, Mercaptopurine, Methotrexate, Mitoxantrone, Nivolumab,    Oxaliplatin, Paclitaxel, Pembrolizumab, Pemetrexed, Revlimid,    Temozolomide, Teniposide, Thioguanine, Valrubicin, Vinblastine,    Vincristine, Vindesine and Vinorelbine.

DESCRIPTION OF DRAWINGS

FIG. 1. Native T-cell responses to PD-L2. (A) Examples of ELISPOTresults for PBMCs isolated from patients with malignant melanoma (AA andMM), in response to PD-L201 (PD-L2(4-12); LLLMLSLEL, SEQ ID NO: 2) andPD-L205 (PD-L2(16-25); QI-AALFTVTV, SEQ ID NO: 4). (B) In-vitro IFN-γELISPOT results. PBMCs from 9 patients with cancer were stimulated oncein vitro with each peptide. Then, the PBMCs were exposed to thepeptides, and IFN-γ secretion was measured with ELISPOT. The responsewas calculated as the number of peptide-specific spots, minus the numberof spots that reacted to an irrelevant peptide (HIV/HLA-A2; pol476-484;ILKEPVHGV, SEQ ID NO: 26), per 5×10⁵ PBMCs.

FIG. 2. PD-L2 elicited responses in T cells from patients with cancerand T cells from healthy donors. (A) Examples of IFN-γ responses againstPD-L201 (PD-L2(4-12)) and PD-L205 (PD-L2(16-25))(black bars) orirrelevant peptide (grey bars) in PBMCs from patients with malignantmelanoma (AA and MM). All experiments were performed in triplicate, **significant according to the DFR and DFRx2. (B) Examples of TNF-αresponses against PD-L201 (PD-L2(4-12)) and PD-L205 (PD-L2(16-25))(black bars) or irrelevant peptide (grey bars) in PBMCs from patientswith malignant melanoma (AA and MM), ** significant according to the DFRand DFRx2; * significant according to only the DFR. (C) In-vitro IFN-γELISPOT results. PBMCs from 9 patients with cancer and 9 healthy donorswere stimulated once in vitro with PD-L201 (PD-L2(4-12)) or PD-L205(PD-L2(16-25)). Then, PBMCs were exposed to the peptides, and IFN-γsecretion was measured with ELISPOT. The average number ofpeptide-specific spots (after subtracting the number of spots withoutadded peptide) was calculated per 2-5×10⁵ PBMCs. (D) Ex vivo IFN-γELISPOT results. PD-L205 (PD-L2(16-25)) (black bars) or the irrelevantpeptide (grey bars) elicited responses in PBMCs from two patients withmalignant melanoma (AA) and in PBMCs from two healthy donors (HD).

FIG. 3: Reactivity towards long PD-L2 peptides spanning the signalpeptide part of the PD-L2 sequence. (A) In vitro IFN-γ ELISPOT results.PBMCs from 11 patients with malignant melanoma and 11 healthy donorswere stimulated with PD-L2long1 (PD-L2(9-29); SLEL-QLHQIAALFTVTVPKEL,SEQ ID NO: 11) or PD-L2long2 (PD-L2(1-25); MIFLLLMLSLELQLHQIAALFTVTV,SEQ ID NO: 12) and screened for IFNγ responses, by measuring IFNγrelease in an in vitro ELISPOT assay. (B) PBMCs from four non-hodgkinlymphoma patients (WM) screened for IFNγ responses towards PD-L2long2(PD-L2(1-25)) in an in vitro ELISPOT assay. All assays were made intriplicates with 3*10{circumflex over ( )}6 cells per well, except onewhich were made in duplicates (WM-2). ** denotes as significantaccording to the DFR and DFRx2; * denotes significant according to onlythe DFR. (C) Examples of ELISPOT well images for WM-5 patient inresponse to PD-L2long2. (D) Intracellular cytokine staining of tumorinfiltrating T-lymphocytes (TILs) from two melanoma patients (TIL2,black bars and TIL6, white bars) shows CD4+ T cell release of IFN-Y,upon exposure to PD-L205 (PD-L2(16-25)), PD-L2long1 (PD-L2(9-29)),PD-L2long2 (PD-L2(1-25)) and a control HIV peptide (HIV-1 pol476-484).

FIG. 4: PD-L2-specific T cells are effector T cells. (A) Intracellularcytokine staining showing CD4+ and CD8+ T cells that release TNF-α inresponse to either an irrelevant control peptide HIV peptide (HIV-1pol476-484) or PD-L205 (PD-L2(16-25)) in cultures of PD-L2 T cells-A(left,) and PD-L2 T cells-B (right). (B) Intracellular TNF-α and IFN-γcytokine staining of PD-L2 T-cells culture-A (left) and PD-L2 T-cellsculture-B (right) in response to 5 hours stimulation with autologousDCs. (C) IFN-γ and TNF-α secretion by PD-L2 T-cell culture-A (top) andPD-L2 T-cell culture-B (bottom) towards PD-L205 (PD-L2(16-25)) peptide(black bars) and autologous DCs when cultured at ratio 1:5 (grey bars)as measured by ELISPOT assay. (D) T2 cells pulsed either with PD-L205(PD-L2(16-25)) or a control HIV peptide (HIV-1 pol476-484) as recognizedby PD-L2 T-cell culture-A (left) and PD-L2 T-cell culture-B (right) in astandard 51Cr-release assay.

FIG. 5: PD-L2 dependent reactivity towards DCs.

(A) Flow cytometric analysis showing profile of PD-L2 surface expressionon autologous DCs transfected with either PD-L2 siRNA or negativecontrol siRNA, 48 hr after electroporation. (B) PD-L2 T-cells culture-A(top) and PD-L2 T-cells culture-B (bottom) were stimulated withautologous DCs transfected PD-L2 siRNA or negative control siRNA for 5hours at a ratio of 1:5 (DC:T-cell). Percentage of cytokine releasingCD4+ T cells (left) and CD8+ T cells (right) was measured usingintracellular cytokine staining. (C) Number of TNF-α releasing T cellsin PD-L2 cultures in response to autologous DCs transfected with eithera negative control siRNA (black bars) or PD-L2 siRNA (grey bars)measured at 48 hours after electroporation using ELISPOT assay. Theassay was performed in triplicate and * denotes significant according tothe DFR.

FIG. 6. No cross-reactivity between PD-L1-specific and PD-L2-specific Tcells. (A) The first 30 amino acid sequences of PD-L1 and PD-L2 and thelocation of the peptides PD-L101 (PDL1(15-23); LLNAFTVTV, SEQ ID NO: 27)and PD-L205 (PD-L2(16-25); QI-AALFTVTV, SEQ ID NO: 4) in the signalpeptide part of the proteins are marked in bold. (B) In vitro IFN-γELISPOT results show responses of T cells from five patients with cancertowards PD-L101 (PDL1(15-23)) and PD-L205 (PD-L2(16-25)) peptides. (C)51Cr-release assay results show percent lysis of T2 cells pulsed withPD-L101 (PDL1(15-23)), PD-L205 (PD-L2(16-25)), or an irrelevant HIVpeptide (HIV-1 pol476-484) when exposed to PD-L101-specific T-cells(CTLs) at different effector-to-target ratios. (D) Intracellularcytokine staining of cultured PD-L101-specific T-cells shows CD8+ T cellrelease of TNF-α, upon exposure to PD-L101 (PDL1(15-23)), PDL205(PD-L2(16-25)), or an irrelevant HIV peptide (HIV-1 pol476-484). (E)Percent lysis of T2-cells, pulsed with PDL205 (PD-L2(16-25)), PD-L101peptide (PDL1(15-23)), or an irrelevant HIV peptide (HIV-1 pol476-484),after exposure to PD-L2 T-cell culture-A (left) or PD-L2 T-cellculture-B (right).

DETAILED DESCRIPTION OF THE INVENTION

In addition to the new immunogenic epitopes from PDL2 (SEQ ID NO 1), andstrong immune responses against the new immunogenic epitopes as well asfrequent immune responses detected against several peptide fragments ofSEQ ID NO 1, the present inventor investigated different PD-L2-derivedepitopes that might elicit T cell reactivity, and tested spontaneousT-cell mediated reactivity against PD-L2 in samples from both healthydonors and patients with different cancers. Finally, it was determinedwhether PD-L2-specific T cells could recognize target cells expressingPD-L2.

Regulatory feedback mechanisms, such as the upregulation of PD-L1 andPD-L2, are essential for limiting the strength and magnitude of immuneresponses that might otherwise harm the host. However, immune evasion isdetrimental in the framework of cancer immunotherapy.

In one aspect, the present invention concerns a peptide compound of PDL2selected from:

a) a peptide fragment of SEQ ID NO 1 consisting of a consecutivesequence of from 8 to 272 amino acids,

b) a functional homologue having at least 70%, 80%, 90%, or 95% identityto SEQ ID NO 1 or the peptide fragment of a), and

c) a functional analogue wherein at least one amino acid has beendeleted, inserted and/or substituted in SEQ ID NO 1 or the peptidefragment of a), and wherein the C-terminal amino acid of any one of a),b) or c) also comprises the amide; or a pharmaceutically acceptable saltthereof.

In the above-mentioned context, “functional” means “capable ofstimulating an immune response to the PDL2 having SEQ ID NO: 1”.

In another aspect the present invention concerns a peptide fragment of ahuman PDL2 protein of SEQ ID NO: 1, which fragment is up to 100 aminoacids in length and wherein the peptide fragment comprises or consistsof a consecutive sequence in a range from 8 to 100 amino acids of SEQ IDNO: 1,

or a pharmaceutically acceptable salt thereof.

In an embodiment the peptide fragment comprises or consists of aconsecutive sequence in the range from 10 to 100 amino acids, such asfrom 10-17 amino acids, 20 to 30 amino acids, 30 to 40 amino acids, orfrom 40 to 50 amino acids.

In another embodiment the peptide fragment consists of a consecutivesequence in the range from 10 to 100 amino acids, such as from 10 to 17amino acids, 20 to 30 amino acids, 30 to 40 amino acids, or from 40 to50 amino acids. In an embodiment the peptide fragment is up to 60 aminoacids in length, such as up to 50 amino acids, up to 40 amino acids, orup to 30 amino acids in length. The corresponding upper range in theconsecutive sequence is accordingly, 60, 50, 40 or 30 amino acids of SEQID NO: 1.

In a further embodiment the peptide fragment is up to 21, 22, 23, 24,25, 26, 27, 28, 29, or 30 amino acids in length.

In a further embodiment the consecutive sequence comprises one or moresequences selected from any one of SEQ ID NO 2, 4, 11 and 12. In a stillfurther embodiment the consecutive sequence comprises the sequence SEQID NO 4. In a further embodiment the consecutive sequence consist of thesequence SEQ ID NO 4. In another embodiment the consecutive sequencecomprises the sequence SEQ ID NO 11. In a further embodiment theconsecutive sequence consist of the sequence SEQ ID NO 11. In anotherembodiment the consecutive sequence comprises the sequence SEQ ID NO 12.In a further embodiment the consecutive sequence consist of the sequenceSEQ ID NO 12. In a further embodiment the consecutive sequence comprisesboth sequences SEQ ID NO 2 and SEQ ID NO 4.

In another embodiment the peptide fragment does not comprise amino acid1-3 of SEQ ID NO 1, that is MIF. Thus, in an embodiment the peptidefragment comprises or consist of LLLMLSLELQLHQIAALFTVTV (SEQ ID NO: 25)

In a further embodiment the consecutive sequence comprises one or moresequences selected from any one of SEQ ID NO 2-12, such as any one ofSEQ ID NO 2, 4, 11 and 12.

In a still further embodiment the consecutive sequence comprises bothSEQ ID NO 2 and SEQ ID NO 4. For instance, the peptide fragment SEQ IDNO: 12 comprises both SEQ ID NO 2 and SEQ ID NO 4.

In a further embodiment the consecutive sequence comprises a sequenceselected from SEQ ID NO 11, wherein the peptide fragment is up to 21,22, 23, 24, 25, 26, 27, 28, 29, or 30 amino acids in length. Typically,21 amino acids in length.

Thus, in a preferred aspect the present invention concerns a peptidefragment of a human PDL2 protein of SEQ ID NO: 1, which peptide fragmentis up to 21, 22, 23, 24, 25, 26, 27, 28, 29, or 30 amino acids in lengthand wherein the peptide fragment comprises or consist of a sequenceselected from SEQ ID NO 11; or a pharmaceutically acceptable saltthereof.

In a still further embodiment the consecutive sequence comprises asequence selected from SEQ ID NO 12, wherein the peptide fragment is upto 25, 26, 27, 28, 29, or 30 amino acids in length.

In a further embodiment the consecutive sequence comprises a sequenceselected from SEQ ID NO 4, wherein the peptide fragment is up to 10, 11,12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29,or 30 amino acids in length.

In a still further embodiment the consecutive sequence comprises asequence selected from SEQ ID NO 2, wherein the peptide fragment is upto 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25,26, 27, 28, 29, or 30 amino acids in length.

In an embodiment, the peptide compound is selected from b) a functionalhomologue having at least 70%, 80%, 90%, or 95% identity to SEQ ID NO 1or the peptide fragment of a), wherein the C-terminal amino acid alsocomprises the amide; or a pharmaceutically acceptable salt thereof. Inone embodiment the functional homologue has at least 80% identity to SEQID NO 1. In a further embodiment the functional homologue has at least90% identity to SEQ ID NO 1. In a further embodiment the functionalhomologue has at least 95% identity to SEQ ID NO 1. In a furtherembodiment the functional homologue has at least 70% identity to thepeptide fragment of a). In a further embodiment the functional homologuehas at least 80% identity to the peptide fragment of a). In a furtherembodiment the functional homologue has at least 90% identity to thepeptide fragment of a). In a further embodiment the functional homologuehas at least 95% identity to the peptide fragment of a).

In another embodiment the peptide compound is selected from c) afunctional analogue wherein at least one amino acid has been deleted,inserted and/or substituted in SEQ ID NO 1 or the peptide fragment ofa), wherein the C-terminal amino acid also comprises the amide; or apharmaceutically acceptable salt thereof.

In a further embodiment, the peptide compound is selected from a) apeptide fragment of SEQ ID NO 1 consisting of a consecutive sequence offrom 8 to 272 amino acids, wherein the C-terminal amino acid alsocomprises the amide; or a pharmaceutically acceptable salt thereof. In afurther embodiment, the peptide fragment consists of a consecutivesequence in the range of from 8 to 250 amino acids. In a still furtherembodiment, the peptide fragment consists of a consecutive sequence inthe range of from 8 to 200 amino acids. In a further embodiment, thepeptide fragment consists of a consecutive sequence in the range of from8 to 150 amino acids. In a still further embodiment, the peptidefragment consists of a consecutive sequence in the range of from 8 to120 amino acids. In a further embodiment, the peptide fragment consistsof a consecutive sequence in the range of from 10 to 100 amino acids. Ina still further embodiment, the peptide fragment consists of aconsecutive sequence in the range of from 20 to 80 amino acids. In afurther embodiment, the peptide fragment consists of a consecutivesequence in the range of from 30 to 60 amino acids. In a still furtherembodiment, the peptide fragment consists of a consecutive sequence inthe range of from 40 to 50 amino acids. In a further embodiment, thepeptide fragment consists of a consecutive sequence in the range of from8 to 30 amino acids. In a still further embodiment, the peptide fragmentconsists of a consecutive sequence in the range of from 10 to 25 aminoacids. In a further embodiment, the peptide fragment consists of aconsecutive sequence in the range of from 8 to 25 amino acids.

In a still further embodiment the peptide fragment of SEQ ID NO 1 isselected from the group consisting of PDL2(1-25), PDL2(1-50),PDL2(1-150), PDL2(1-200), PDL2(50-100), PDL2(50-150), PDL2(50-200),PDL2(60-100), PDL2(60-150), PDL2(60-200), PDL2(70-100), PDL2(70-150),PDL2(70-200), PDL2(200-273), and PDL2(210-250). In a preferredembodiment, the peptide fragment of SEQ ID NO 1 is selected fromPDL2(1-25). In another preferred embodiment, the peptide fragment of SEQID NO 1 is selected from PDL2(1-50). In a further preferred embodiment,the peptide fragment of SEQ ID NO 1 is selected from PDL2(200-273). In apreferred embodiment, the peptide fragment of SEQ ID NO 1 is selectedfrom PDL2(210-250).

In a further embodiment, the consecutive sequence comprises one or moresequences selected from any one of SEQ ID NO 2-24, such as one sequenceselected from SEQ ID NO 7 or two sequence selected from SEQ ID NO 2 and4. In a preferred embodiment, the consecutive sequence is selected fromSEQ ID NO 4. In a preferred embodiment, the consecutive sequence isselected from SEQ ID NO 2. In a preferred embodiment, the consecutivesequence is selected from SEQ ID NO 7.

It is to be understood that when the peptide fragment consists of aconsecutive sequence in the range of from 8 to 120, it may at the sametime be selected within the sequence of for instance PDL2(1-150),whereas a peptide fragment consisting of a consecutive sequence in therange of from 8 to 272, cannot be at the same time be selected withinthe sequence of for instance PDL2(1-150), this is known to the personskilled in the art. Otherwise all combinations are contemplated withinthe present invention.

It is also to be understood that PDL2(x-y), wherein x and y are integersselected from 1-273 as used herein means a peptide fragment of humanextended PDL2 having the SEQ ID NO 1 as defined herein, wherein x is theN-terminal amino acid and y is the C-terminal amino acid, for instancePDL2(16-25) indicates the peptide fragment from amino acid 16 of SEQ IDNO 1 to amino acid 25 of SEQ ID NO 1 wherein amino acid 16 is Q andamino acid 25 is V.

In any peptide fragment described herein, the C terminal amino acid mayoptionally be replaced with the corresponding amide, to improvesolubility and/or to aid with manufacture/isolation. Similarly, thepolypeptide may have attached at the N and/or C terminus at least oneadditional moiety to improve solubility and/or to aid withmanufacture/isolation. Suitable moieties include hydrophilic aminoacids. For example, the amino acids KR may be added at the N terminusand/or the amino acids RK may be added in order at the C terminus.

In a further aspect the present invention relates to a compositioncomprising a peptide fragment of a human PDL2 protein of SEQ ID NO: 1,which fragment is up to 100 amino acids in length and wherein thepeptide fragment comprises or consists of a consecutive sequence in arange from 8 to 100 amino acids of SEQ ID NO: 1, or a pharmaceuticallyacceptable salt thereof; optionally together with a pharmaceuticallyacceptable additive, such as a carrier or adjuvant.

The term “identity” as used herein refers to a relationship between thesequences of two or more peptides, such as polypeptides, as determinedby comparing the sequences. In the art, “identity” also means the degreeof sequence relatedness between proteins or polypeptides, as determinedby the number of matches between strings of two or more amino acidresidues. “Identity” measures the percent of identical matches betweenthe smaller of two or more sequences with gap alignments (if any)addressed by a particular mathematical model or computer program (i.e.,“algorithms”). Identity of related proteins or peptides can be readilycalculated by known methods. Such methods include, but are not limitedto, those described in Computational Molecular Biology, Lesk, A. M.,ed., Oxford University Press, New York, 1988; Biocomputing: Informaticsand Genome Projects, Smith, D. W., ed., Academic Press, New York, 1993;Computer Analysis of Sequence Data, Part 1, Griffin, A. M., and Griffin,H. G., eds., Humana Press, New Jersey, 1994; Sequence Analysis inMolecular Biology, von Heinje, G., Academic Press, 1987; SequenceAnalysis Primer, Gribskov, M. and Devereux, J., eds., M. Stockton Press,New York, 1991; and Carillo et al., SIAM J. Applied Math., 48, 1073,(1988).

Preferred methods to determine identity are designed to give the largestmatch between the sequences tested. Methods to determine identity aredescribed in publicly available computer programs. Preferred computerprogram methods to determine identity between two sequences include theGCG program package, including GAP (Devereux et al., Nucl. Acid. Res.,12, 387, (1984); Genetics Computer Group, University of Wisconsin,Madison, Wis.), BLASTP, BLASTN, and FASTA (Altschul et al., J. Mol.Biol., 215, 403-410, (1990)). The BLASTX program is publicly availablefrom the National Center for Biotechnology Information (NCBI) and othersources (BLAST Manual, Altschul et al. NCB/NLM/NIH Bethesda, Md. 20894;Altschul et al., supra). The well-known Smith Waterman algorithm mayalso be used to determine identity.

For example, using the computer algorithm GAP (Genetics Computer Group,University of Wisconsin, Madison, Wis.), two proteins for which thepercent sequence identity is to be determined are aligned for optimalmatching of their respective amino acids (the “matched span”, asdetermined by the algorithm). A gap opening penalty (which is calculatedas 3 times the average diagonal; the “average diagonal” is the averageof the diagonal of the comparison matrix being used; the “diagonal” isthe score or number assigned to each perfect amino acid match by theparticular comparison matrix) and a gap extension penalty (which isusually 1/10 times the gap opening penalty), as well as a comparisonmatrix such as PAM 250 or BLOSUM 62 are used in conjunction with thealgorithm. A standard comparison matrix (see Dayhoff et al., Atlas ofProtein Sequence and Structure, vol. 5, supp.3 (1978) for the PAM 250comparison matrix; Henikoff et al., Proc. Natl. Acad. Sci USA, 89,10915-10919, (1992) for the BLOSUM 62 comparison matrix) is also used bythe algorithm. Preferred parameters for a protein or peptide sequencecomparison include the following: Algorithm: Needleman et al., J. Mol.Biol, 48, 443-453, (1970); Comparison matrix: BLOSUM 62 from Henikoff etal., Proc. Natl. Acad. Sci. USA, 89, 10915-10919, (1992); Gap Penalty:12, Gap Length Penalty: 4, Threshold of Similarity: 0. The GAP programis useful with the above parameters. The aforementioned parameters arethe default parameters for protein comparisons (along with no penaltyfor end gaps) using the GAP algorithm.

In a still further embodiment the peptide fragment under a), thefunctional homologue under b), or the functional analogue under c) iscapable of activating T-cells, such as CD4 and CD8 T-cells. Typically,the activation is determined by the ELISPOT assay described herein.

In a further embodiment, the peptide fragment under a) is capable ofactivating T-cells as determined by the ELISPOT assay described herein.

In a further aspect the present invention relates to a nucleic acidencoding the peptide compound of the present invention. The peptidecompound of the present invention is selected from any one of the aboveembodiments. In one embodiment the nucleic acid is selected from thegroup consisting of DNA and RNA.

In a still further aspect the present invention relates to a vectorcomprising the nucleic acid of the present invention. The nucleic acidof the present invention is selected from any one of the aboveembodiments, and the peptide compound of the present invention isselected from any one of the above embodiments. In one embodiment thevector is selected from a virus vector.

In a further aspect the present invention relates to a host cellcomprising the vector of the present invention. The vector of thepresent invention is selected from any one of the above embodiments, thenucleic acid of the present invention is selected from any one of theabove embodiments, and the peptide compound of the present invention isselected from any one of the above embodiments. In one embodiment thehost cell is selected from a mammalian cell.

In a still further aspect the present invention relates to a compositioncomprising the peptide compound or fragment of the present invention orthe nucleic acid of the present invention or the vector of the presentinvention or the host cell of the present invention, optionally togetherwith a pharmaceutically acceptable additive, such as carrier oradjuvant.

In a still further aspect the present invention relates to a compositioncomprising

a) the peptide compound or fragment of the present invention or thenucleic acid of the present invention or the vector of the presentinvention or the host cell of the present invention; and

b) an adjuvant;

for use as a medicament.

In an embodiment the composition of the present invention is for use ina method for treatment or prevention of a disease, disorder or conditionselected from cancer. In one embodiment the cancer is a tumor formingcancer disease. In a further embodiment the cancer is selected from anyone of melanoma, renal cell carcinoma, non-hodgkin lymphoma, and ovariancancer. In a further embodiment the adjuvant is selected from the groupconsisting of bacterial DNA based adjuvants, oil/surfactant basedadjuvants, viral dsRNA based adjuvants, imidazochinilines, and aMontanide ISA adjuvant.

In a further aspect the present invention relates to a kit-of-partscomprising;

a) the composition of the present invention, and

b) a composition comprising at least one second active ingredient,selected from an immunostimulating compound, such as an interleukin,e.g. IL-2 and or IL-21, an anti-cancer agent, such as a chemotherapeuticagent, e.g. Actimide, Azacitidine, Azathioprine, Bleomycin, Carboplatin,Capecitabine, Cisplatin, Chlorambucil, Cyclophosphamide, Cytarabine,Daunorubicin, Docetaxel, Doxifluridine, Doxorubicin, Epirubicin,Etoposide, Fludarabine, Fluorouracil, Gemcitabine, Hydroxyurea,Idarubicin, Irinotecan, Lenalidomide, Leucovorin, Mechlorethamine,Melphalan, Mercaptopurine, Methotrexate, Mitoxantrone, nivolumab,Oxaliplatin, Paclitaxel, pembrolizumab, Pemetrexed, Revlimid,Temozolomide, Teniposide, Thioguanine, Valrubicin, Vinblastine,Vincristine, Vindesine and Vinorelbine.

In an embodiment of the kits-of-parts, the provided compositions are tobe administered simultaneously or sequentially.

In a further aspect, the present invention relates to a method oftreating a clinical condition characterized by expression of PDL2 of SEQID NO 1, the method comprising administering to an individual sufferingfrom said clinical condition an effective amount of the peptide compoundof the present invention or the nucleic acid of the present invention orthe vector of the present invention or the host cell of the presentinvention.

In a still further aspect the present invention relates to use of thepeptide compound of the present invention, or the nucleic acid of thepresent invention, or the vector of the present invention, or the hostcell of the present invention, for the manufacture of a medicament, suchas an composition or vaccine, for the treatment or prevention of acancer characterized by expression of PDL2.

In a further aspect, the present invention relates to the peptidecompound of the present invention, or the nucleic acid of the presentinvention, or the vector of the present invention, or the host cell ofthe present invention, for use in a method for treatment or preventionof a cancer, when administered simultaneously or sequentially with anadditional cancer therapy.

In an embodiment the additional cancer therapy is selected from thegroup consisting of a cytokine therapy, a T-cell therapy, an NK therapy,an immune system checkpoint inhibitor, chemotherapy, radiotherapy,immunostimulating substances, gene therapy, anti-bodies and dendriticcells. In one embodiment the additional cancer therapy is selected froman immune system checkpoint inhibitor. In a particular embodiment, theimmune system checkpoint inhibitor is a checkpoint blocking antibody. Ina further embodiment the additional cancer therapy is selected from thegroup consisting of Actimide, Azacitidine, Azathioprine, Bleomycin,Carboplatin, Capecitabine, Cisplatin, Chlorambucil, Cyclophosphamide,Cytarabine, Daunorubicin, Docetaxel, Doxifluridine, Doxorubicin,Epirubicin, Etoposide, Fludarabine, Fluorouracil, Gemcitabine,Hydroxyurea, Idarubicin, Irinotecan, Lenalidomide, Leucovorin,Mechlorethamine, Melphalan, Mercaptopurine, Methotrexate, Mitoxantrone,Nivolumab, Oxaliplatin, Paclitaxel, Pembrolizumab, Pemetrexed, Revlimid,Temozolomide, Teniposide, Thioguanine, Valrubicin, Vinblastine,Vincristine, Vindesine and Vinorelbine.

As used herein any amino acid sequence shown may be modified at theC-terminal amino acid to be on amide form (—CONH₂) or may be on acidform (—COOH), thus any one of these are preferred embodiments, and it isintended that any C-terminal amino acid, such as I, L, V, comprises bothamide and acid form unless specified by —NH₂ or —OH.

The PDL2 peptide fragments disclosed herein are made by standard peptidesynthesis, such as solid-phase peptide synthesis (SPPS). SPPS is astandard method for synthesizing peptides in the lab. SPPS allows forthe synthesis of natural peptides which are difficult to express inbacteria, the incorporation of unnatural amino acids, peptide/proteinbackbone modification, and the synthesis of D-proteins, which consist ofD-amino acids. Small porous beads are treated with functional units(‘linkers’) on which peptide chains can be built. The peptide willremain covalently attached to the bead until cleaved from it by areagent such as anhydrous hydrogen fluoride or trifluoroacetic acid. Thepeptide is thus ‘immobilized’ on the solid-phase and can be retainedduring a filtration process while liquid-phase reagents and by-productsof synthesis are flushed away. The general principle of SPPS is one ofrepeated cycles of deprotection-wash-coupling-wash. The free N-terminalamine of a solid-phase attached peptide is coupled to a singleN-protected amino acid unit. This unit is then deprotected, revealing anew N-terminal amine to which a further amino acid may be attached. Thesuperiority of this technique partially lies in the ability to performwash cycles after each reaction, removing excess reagent with all of thegrowing peptide of interest remaining covalently attached to theinsoluble resin. There are two majorly used forms of SPPS-Fmoc and Boc.Unlike ribosome protein synthesis, solid-phase peptide synthesisproceeds in a C-terminal to N-terminal fashion. The N-termini of aminoacid monomers is protected by either of these two groups and added ontoa deprotected amino acid chain. Automated synthesizers are available forboth techniques, though many research groups continue to perform SPPSmanually. Furthermore, the skilled person will under-stand that theprocesses described above and hereinafter the functional groups ofintermediate compounds may need to be protected by protecting group.

When the peptide compounds, nucleic acids, vectors, host cells andpharmaceutical compositions herein disclosed are used for the abovetreatment, a therapeutically effective amount of at least one compoundis administered to a mammal in need of said treatment.

As used herein amino acids are identified by the one or three lettercode known to the person skilled in the art and shown in the table belowfor convenience:

Amino acids, one and three letter codes Amino acid Three letter code Oneletter code alanine ala A arginine arg R asparagine asn N aspartic acidasp D asparagine or aspartic acid asx B cysteine cys C glutamic acid gluE glutamine gln Q glutamine or glutamic acid glx Z glycine gly Ghistidine his H isoleucine ile I leucine leu L lysine lys K methioninemet M phenylalanine phe F proline pro P serine ser S threonine thr Ttryptophan trp W tyrosine tyr Y valine val V

The term “immunogenic” as used herein means that a peptide fragment iscapable of eliciting an immune response, preferably a T-cell response,in at least one individual after administration to said individual. Apolypeptide may be identified as immunogenic using any suitable method,including in vitro methods. For example, a peptide may be identified asimmunogenic if it has at least one of the following characteristics:

-   -   (i) It is capable of eliciting IFN-γ-producing cells in a PBL        population of at least one cancer patient as determined by an        ELISPOT assay, and/or    -   (ii) It is capable of in situ detection in a sample of tumor        tissue of CTLs that are reactive with the corresponding PDL2;        and/or    -   (iii) It is capable of inducing the in vitro growth of specific        T-cells.        Methods suitable for determining whether a polypeptide is        immunogenic active are also provided in the Examples section        below.

The term “treatment” and “treating” as used herein means the managementand care of a patient for the purpose of combating a condition, such asa disease or a disorder. The term is intended to include the fullspectrum of treatments for a given condition from which the patient issuffering, such as administration of the active compound to alleviatethe symptoms or complications, to delay the progression of the disease,disorder or condition, to alleviate or relief the symptoms andcomplications, and/or to cure or eliminate the disease, disorder orcondition as well as to prevent the condition, wherein prevention is tobe understood as the management and care of a patient for the purpose ofcombating the disease, condition, or disorder and includes theadministration of the active compounds to prevent the onset of thesymptoms or complications. The treatment may either be performed in anacute or in a chronic way. The patient to be treated is preferably amammal; in particular a human being, but it may also include animals,such as dogs, cats, cows, monkeys, apes, sheep and pigs.

The term “a therapeutically effective amount” of a peptide compound ofthe present invention or a peptide fragment disclosed herein, as usedherein means an amount sufficient to cure, alleviate or partially arrestthe clinical manifestations of a given disease and its complications. Anamount adequate to accomplish this is defined as “therapeuticallyeffective amount”. Effective amounts for each purpose will depend on theseverity of the disease or injury as well as the weight and generalstate of the subject. It will be understood that determining anappropriate dosage may be achieved using routine experimentation, byconstructing a matrix of values and testing different points in thematrix, which is all within the ordinary skills of a trained physicianor veterinary.

In a still further aspect the present invention relates to apharmaceutical composition comprising the peptide compound, such aspeptide fragment, of the present invention and optionally apharmaceutically acceptable additive, such as a carrier or an excipient.

As used herein “pharmaceutically acceptable additive” is intendedwithout limitation to include carriers, excipients, diluents, adjuvant,colorings, aroma, preservatives etc. that the skilled person wouldconsider using when formulating a compound of the present invention inorder to make a pharmaceutical composition.

The adjuvants, diluents, excipients and/or carriers that may be used inthe composition of the invention must be pharmaceutically acceptable inthe sense of being compatible with the peptide compound, peptidefragment, nucleic acid, vector, or host cell and the other ingredientsof the pharmaceutical composition, and not deleterious to the recipientthereof. It is preferred that the compositions shall not contain anymaterial that may cause an adverse reaction, such as an allergicreaction. The adjuvants, diluents, excipients and carriers that may beused in the pharmaceutical composition of the invention are well knownto a person within the art.

Adjuvants are any substance whose admixture into the compositionincreases or otherwise modifies the immune response elicited by thecomposition. Adjuvants, broadly defined, are substances which promoteimmune responses. Adjuvants may also preferably have a depot effect, inthat they also result in a slow and sustained release of an active agentfrom the administration site. A general discussion of adjuvants isprovided in Goding, Monoclonal Antibodies: Principles & Practice (2ndedition, 1986) at pages 61-63.

Adjuvants may be selected from the group consisting of: AlK(SO4)2,AlNa(SO4)2, AlNH4 (SO4), silica, alum, Al(OH)3, Ca3 (PO4)2, kaolin,carbon, aluminum hydroxide, muramyl dipeptides,N-acetyl-muramyl-L-threonyl-D-isoglutamine (thr-DMP),N-acetyl-nornuramyl-L-alanyl-D-isoglutamine (CGP 11687, also referred toas nor-MDP),N-acetylmuramyul-L-alanyl-D-isoglutaminyl-L-alanine-2-(1′2′-dipalmitoyl-sn-glycero-3-hydroxphosphoyloxy)-(CGP19835A, also referred to as MTP-PE), RIBI (MPL+TDM+CWS) in a 2%squalene/Tween-80® emulsion, lipopolysaccharides and its variousderivatives, including lipid A, Freund's Complete Adjuvant (FCA),Freund's Incomplete Adjuvants, Merck Adjuvant 65, polynucleotides (forexample, poly IC and poly AU acids), wax D from Mycobacteriumtuberculosis, substances found in Corynebacterium parvum, Bordetellapertussis, and members of the genus Brucella, Titermax, ISCOMS, Quil A,ALUN (see U.S. Pat. Nos. 58,767, 5,554,372), Lipid A derivatives,choleratoxin derivatives, HSP derivatives, LPS derivatives, syntheticpeptide matrixes or GMDP, Interleukin 1, Interleukin 2, Montanide ISA-51and QS-21. Various saponin extracts have also been suggested to beuseful as adjuvants in immunogenic compositions. Granulocyte-macrophagecolony stimulating factor (GM-CSF) may also be used as an adjuvant.

Preferred adjuvants to be used with the invention include oil/surfactantbased adjuvants such as Montanide adjuvants (available from Seppic,Belgium), preferably Montanide ISA-51. Other preferred adjuvants arebacterial DNA based adjuvants, such as adjuvants including CpGoligonucleotide sequences. Yet other preferred adjuvants are viral dsRNAbased adjuvants, such as poly I:C. GM-CSF and Imidazochinilines are alsoexamples of preferred adjuvants.

The adjuvant is most preferably a Montanide ISA adjuvant. The MontanideISA adjuvant is preferably Montanide ISA 51 or Montanide ISA 720.

In Goding, Monoclonal Antibodies: Principles & Practice (2nd edition,1986) at pages 61-63 it is also noted that, when an antigen of interestis of low molecular weight, or is poorly immunogenic, coupling to animmunogenic carrier is recommended. A peptide compound, peptidefragment, nucleic acid, vector, or host cell of an composition of theinvention may be coupled to a carrier. A carrier may be presentindependently of an adjuvant. The function of a carrier can be, forexample, to increase the molecular weight of the peptide compound,peptide fragment, nucleic acid, vector, or host cell in order toincrease activity or immunogenicity, to confer stability, to increasethe biological activity, or to increase serum half-life. Furthermore, acarrier may aid in presenting the polypeptide or fragment thereof toT-cells. Thus, in the immunogenic composition, the polypeptide orfragment thereof may be associated with a carrier, such as those set outbelow.

The carrier may be any suitable carrier known to a person skilled in theart, for example a protein or an antigen presenting cell, such as adendritic cell (DC). Carrier proteins include keyhole limpet hemocyanin,serum proteins such as transferrin, bovine serum albumin, human serumalbumin, thyroglobulin or ovalbumin, immunoglobulins, or hormones, suchas insulin or palmitic acid. Alternatively, the carrier protein may betetanus toxoid or diphtheria toxoid. Alternatively, the carrier may be adextran such as sepharose. The carrier must be physiologicallyacceptable to humans and safe.

The composition may optionally comprise a pharmaceutically acceptableexcipient. The excipient must be ‘acceptable’ in the sense of beingcompatible with the other ingredients of the composition and notdeleterious to the recipient thereof. Auxiliary substances, such aswetting or emulsifying agents, pH buffering substances and the like, maybe present in the excipient. These excipients and auxiliary substancesare generally pharmaceutical agents that do not induce an immuneresponse in the individual receiving the composition, and which may beadministered without undue toxicity. Pharmaceutically acceptableexcipients include, but are not limited to, liquids such as water,saline, polyethyleneglycol, hyaluronic acid, glycerol and ethanol.Pharmaceutically acceptable salts can also be included therein, forexample, mineral acid salts such as hydrochlorides, hydrobromides,phosphates, sulfates, and the like; and the salts of organic acids suchas acetates, propionates, malonates, benzoates, and the like. A thoroughdiscussion of pharmaceutically acceptable excipients, vehicles andauxiliary substances is available in Remington's Pharmaceutical Sciences(Mack Pub. Co., N.J. 1991).

The composition may be prepared, packaged, or sold in a form suitablefor bolus administration or for continuous administration. Injectablecompositions may be prepared, packaged, or sold in unit dosage form,such as in ampoules or in multi-dose containers containing apreservative. Compositions include, but are not limited to, suspensions,solutions, emulsions in oily or aqueous vehicles, pastes, andimplantable sustained-release or biodegradable formulations. In oneembodiment of a composition, the active ingredient is provided in dry(for e.g., a powder or granules) form for reconstitution with a suitablevehicle (e.g., sterile pyrogen-free water) prior to administration ofthe reconstituted composition. The composition may be prepared,packaged, or sold in the form of a sterile injectable aqueous or oilysuspension or solution. This suspension or solution may be formulatedaccording to the known art, and may comprise, in addition to the activeingredient, additional ingredients such as the adjuvants, excipients andauxiliary substances described herein. Such sterile injectableformulations may be prepared using a non-toxic parenterally-acceptablediluent or solvent, such as water or 1,3-butane diol, for example. Otheracceptable diluents and solvents include, but are not limited to,Ringer's solution, isotonic sodium chloride solution, and fixed oilssuch as synthetic mono- or di-glycerides.

Other compositions which are useful include those which comprise theactive ingredient in microcrystalline form, in a liposomal preparation,or as a component of a biodegradable polymer systems. Compositions forsustained release or implantation may comprise pharmaceuticallyacceptable polymeric or hydrophobic materials such as an emulsion, anion exchange resin, a sparingly soluble polymer, or a sparingly solublesalt. Alternatively, the active ingredients of the composition may beencapsulated, adsorbed to, or associated with, particulate carriers.Suitable particulate carriers include those derived from polymethylmethacrylate polymers, as well as PLG microparticles derived frompoly(lactides) and poly(lactide-co-glycolides). See, e.g., Jeffery etal. (1993) Pharm. Res. 10:362-368. Other particulate systems andpolymers can also be used, for example, polymers such as polylysine,polyarginine, polyornithine, spermine, spermidine, as well as conjugatesof these molecules.

As mentioned above, the compositions and particularly immunotherapeticcompositions as herein disclosed may, in addition to the compoundsherein disclosed, further comprise at least one pharmaceuticallyacceptable adjuvant, diluent, excipient and/or carrier. In someembodiments, the pharmaceutical compositions comprise from 1 to 99weight % of said at least one pharmaceutically acceptable adjuvant,diluent, excipient and/or carrier and from 1 to 99 weight % of acompound as herein disclosed. The combined amount of the activeingredient and of the pharmaceutically acceptable adjuvant, diluent,excipient and/or carrier may not constitute more than 100% by weight ofthe composition, particularly the pharmaceutical composition.

In some embodiments, only one compound or peptide as herein disclosed isused for the purposes discussed above.

In some embodiments, two or more of the compound as herein disclosed areused in combination for the purposes discussed above.

The composition, particularly immunotherapeutic composition comprising acompound set forth herein may be adapted for oral, intravenous, topical,intraperitoneal, nasal, buccal, sublingual, or subcutaneousadministration, or for administration via the respiratory tract in theform of, for example, an aerosol or an air-suspended fine powder.Therefore, the pharmaceutical composition may be in the form of, forexample, tablets, capsules, powders, nanoparticles, crystals, amorphoussubstances, solutions, transdermal patches or suppositories.

Further embodiments of the process are described in the experimentalsection herein, and each individual process as well as each startingmaterial constitutes embodiments that may form part of embodiments.

The above embodiments should be seen as referring to any one of theaspects (such as ‘method for treatment’, ‘ composition’, ‘peptidecompound for use as a medicament’, or ‘peptide compound for use in amethod’) described herein as well as any one of the embodimentsdescribed herein unless it is specified that an embodiment relates to acertain aspect or aspects of the present invention.

All references, including publications, patent applications and patents,cited herein are hereby incorporated by reference to the same extent asif each reference was individually and specifically indicated to beincorporated by reference and was set forth in its entirety herein.

All headings and sub-headings are used herein for convenience only andshould not be construed as limiting the invention in any way.

Any combination of the above-described elements in all possiblevariations thereof is encompassed by the invention unless otherwiseindicated herein or otherwise clearly contradicted by context.

The terms “a” and “an” and “the” and similar referents as used in thecontext of describing the invention are to be construed to cover boththe singular and the plural, unless otherwise indicated herein orclearly contradicted by context.

Recitation of ranges of values herein are merely intended to serve as ashorthand method of referring individually to each separate valuefalling within the range, unless otherwise indicated herein, and eachseparate value is incorporated into the specification as if it wereindividually recited herein. Unless otherwise stated, all exact valuesprovided herein are representative of corresponding approximate values(e.g., all exact exemplary values provided with respect to a particularfactor or measurement can be considered to also pro-vide a correspondingapproximate measurement, modified by “about,” where appropriate).

All methods described herein can be performed in any suitable orderunless otherwise indicated herein or otherwise clearly contradicted bycontext.

The use of any and all examples, or exemplary language (e.g., “such as”)provided herein, is intended merely to better illuminate the inventionand does not pose a limitation on the scope of the invention unlessotherwise indicated. No language in the specification should beconstrued as indicating any element is essential to the practice of theinvention unless as much is explicitly stated.

The citation and incorporation of patent documents herein is done forconvenience only and does not reflect any view of the validity,patentability and/or enforceability of such patent documents.

The description herein of any aspect or embodiment of the inventionusing terms such as “comprising”, “having”, “including” or “containing”with reference to an element or elements is intended to provide supportfor a similar aspect or embodiment of the invention that “consists of”,“consists essentially of”, or “substantially comprises” that particularelement or elements, unless otherwise stated or clearly contradicted bycontext (e.g., a composition described herein as comprising a particularelement should be understood as also describing a composition consistingof that element, unless otherwise stated or clearly contradicted bycontext).

This invention includes all modifications and equivalents of the subjectmatter recited in the aspects or claims presented herein to the maximumextent permitted by applicable law.

The present invention is further illustrated by the following examplesthat, however, are not to be construed as limiting the scope ofprotection. The features disclosed in the foregoing description and inthe following examples may, both separately and in any combinationthereof, be material for realizing the invention in diverse formsthereof.

EXPERIMENTAL

Patients, Protocols, Methods and Discussion

Patient Material

We collected blood samples from patients with melanoma, renal cellcarcinoma, non-hodgkin lymphoma, and ovarian cancer and from healthy.Samples were collected a minimum of four weeks after the termination ofany kind of anti-cancer therapy. Peripheral blood mononuclear cells(PBMCs) were isolatedusing Lymphoprep™ (Alere AS, cat. 1114547)separation, HLA-typed and frozen in FCS with 10% DMSO (Sigma-Aldrich,cat. D5879-100ML). Tumor Infiltrating lymphocytes (TIL) from lesionsfrom two melanoma patients were expanded using high dose IL-2 (6000units/ml). The protocol was approved by the Scientific Ethics Committeefor The Capital Region of Denmark and conducted in accordance with theprovisions of the Declaration of Helsinki. Before study entry, a writteninformed consent from the patients was obtained.

Peptides

We identified 22 HLA-A2 restricted, 9-10 amino acid-long peptides in thehuman PD-L2 protein with an online epitope prediction database,SYFPEITHI (www.syfpeithi.de). Of these 22 peptides, we selected 9, fromeither the signal sequence or the transmembrane domain of PD-L2, and hadthem synthesized by TAG Copenhagen (Copenhagen, Denmark). These peptideswere: PD-L201 (PD-L2(4-12); LLLMLSLEL, SEQ ID NO: 2), PD-L204(PD-L2(231-240); IIAFIFIATV, SEQ ID NO:3), PD-L205 (PD-L2(16-25);QIAALFTVTV, SEQ ID NO: 4), PD-L208 (PD-L2(6-14); LMLSLELQL, SEQ ID NO:5), PD-L209 (PD-L2(9-17); SLEL-QLHQI, SEQ ID NO: 6), PD-L215(PD-L2(234-243); FIFIATVIAL, SEQ ID NO: 7), PD-L216 (PD-L2(11-20);ELQLHQIAAL, SEQ ID NO:8), PD-L220 (PD-L2(1-10); MIFLLLMLSL, SEQ ID NO:9), and PD-L222 (PD-L2(226-235); FIPFCIIAFI, SEQ ID NO: 10). We alsoanalyzed two peptides with 21-25 amino acids: PD-L2long1 (PD-L2(9-29);SLELQLHQIAALFTVTVPKEL, SEQ ID NO: 11) and PD-L2long2 (PD-L2(1-25);MIFLLLMLSLELQLHQIAALFTVTV, SEQ ID NO: 12). The HLA-A2 high affinitybinding epitope, HIV-1 pol476-484 (ILKEPVHGV; SEQ ID NO 26), was used asan irrelevant control. A previously described PD-L1 peptide named asPD-L101 (PDL1(15-23); LLNAFTVTV; SEQ ID NO 27) was used in crossreactivity experiments (1). All peptides were dissolved in either DMSOor sterile water before the experiments.

ELISPOT Assay

The IFN-γ and TNF-α ELISPOT technique was performed as describedpreviously (3). We performed the assays according to the guidelinesprovided by the cancer immunotherapy immunoguiding program (CIP;cimt.eu/cimt/files/d1/cip_guidelines.pdf). Unless stated otherwise,PBMCs were stimulated once in vitro with peptide prior to analysis toextend the sensitivity of the assay. To measure T-cell reactivity,nitrocellulose-bottomed 96-well plates (MultiScreen MSIPN4W; Millipore)were coated overnight at room temperature or two days at 4° C. with therelevant antibodies. The wells were washed and blocked with X-vivomedium for 2 h. The PBMCs were added at different cell concentrations intriplicate wells, with PD-L2 peptide or with control peptide, andincubated overnight. The following day, the wells were washed, and therelevant biotinylated secondary antibody (Mabtech) was added, followedby the avidin-enzyme conjugate (AP-Avidin; Calbiochem/Invitrogen LifeTechnologies); finally, we added the enzyme substrate, NBT/BCIP(Invitrogen Life Technologies) for visualization. The spots on thedeveloped ELISPOT plates were analyzed on a CTL ImmunoSpot S6 Ultimate-Vanalyzer with Immunospot software, v5.1.

Generation of PD-L2-Specific T-Cell Cultures

PBMCs from a patient with melanoma were stimulated with irradiated (30Gy) autologous DCs, which had been pulsed with PD-L205 (PD-L2(16-25))peptide (PBL:DC ratio 10:1) and IL-7 (40 U/ml) were added (PeproTech,London, UK). The next day, IL-12 (20 U/ml) was added (PeproTech, London,UK). At weekly intervals, we performed three identical stimulations,with irradiated autologous DCs loaded with PDL205 (PD-L2(16-25)), andIL-12 (20 U/ml) added the next day. Then, at weekly intervals, westimulated the culture three more times with irradiated autologous PBLsloaded with PDL205 (PD-L2(16-25)) (culture:PBL ratio 1:1), but the nextday, we added IL-2 (120 U/ml; Proleukin, Novartis).

The culture was enriched for specific T cells, either by staining withan anti-CD137-PE antibody (BD-Biosciences) or by employing aTNF-α-enrichment and detection kit (according to the procedure byMiltenyi Biotec). Next, we performed magnetic cell isolation with a MACsmicrobead column (according to the procedure by Miltenyi Biotec). Thesorted cells were rapidly expanded by incubating with 0.6 μg anti-CD3antibody (eBioscience, clone OKT3) and a high dose of IL-2 (Proleukin,Novartis).

Intracellular Cytokine Staining

To detect cell subpopulations that produced cytokines, we stimulated aPD-L1-specific T-cell culture (previously described (1)) and aPD-L2-specific T-cell culture with 5 μg/ml of relevant or irrelevantpeptide, and incubated the cells for 5 h at 37° C. with 5% CO2. After 1h of incubation, we added GolgiPlug (BD), diluted at 1:200. After 4 h,cells were washed twice with PBS, stained with fluorochrome-conjugatedantibodies specific for surface markers (CD3-APC-H7, CD4-PerCP/FITC,CD8-Pacific Blue/PerCP, and Horizon Fixable Viability Stain 510, allfrom BD). Cells were washed, fixed, and permeabilized withFixation/Permeabilization and Permeabilization Buffer (eBioscience),according to the manufacturer's instructions. Cells were subsequentlystained with fluorochrome-conjugated antibodies to visualizeintracellular cytokines. The following antibody-fluorochromecombinations were used: IFNγ-PE-CY7/APC (eBioscience) and TNFα-APC/BV421(eBioscience). Relevant isotype controls were used to enable correctcompensation and confirm antibody specificity. Stained cells wereanalyzed with a BD FACSCanto II flow cytometer. Analysis was performedwith BD FACSDiva Software.

Cytotoxicity Assay

PD-L1-specific and PD-L2-specific T-cell-mediated cytotoxicity wasmeasured with conventional 51chromium-release assays, as previouslydescribed (4). Target cells were TAP deficient T2 cells, pulsed withHIV-1 pol476-484 (ILKEPVHGV, SEQ ID NO: 26), PD-L101 (PD-L1(15-23)), orPD-L205 (PD-L2(16-25)).

siRNA-Mediated PD-L2 Silencing of DCs

All Silencer® Select siRNA duplexes for targeted silencing of PD-L2 andSilencer® Select siRNA negative control duplex for medium GC contentwere obtained from Ambion® by Life Technology.

The PD-L2 siRNA duplexes consisted of three transcripts: 1. (sence)5′-CAUCCU-AAAGGUUCCAGAAtt-3′ (SEQ ID NO 28), (antisense) 5′-UUCUGGAACCUUUAG-GAUGtg3′ (SEQ ID NO 29)-(siRNA ID #s37285), 2. (sense)5′-CCUAAGGAACUGUACAUAAtt-3′ (SEQ ID NO 30), (antisense)5′-UUAUGUA-CAGUUCCUUAGGga 3′ (SEQ ID NO 31)-(siRNA ID #s37286) and 3.(sence) 5′-GAAAACAACUCUGUCAAAAtt-3′ (SEQ ID NO 32), (antisense)5′-UUUU-GACAGAGUUGUUUUCtt 3′ (SEQ ID NO 33)-(siRNA ID #s37287). ThesiRNA duplexes were dissolved in RNase-free water to a finalconcentration of 100 μM and subsequently stored at −80° C.

Autologous CD14+ monocytes were enriched using MACS CD14 MicroBeads(Miltenyi Biotech). The enriched monocytes were cultured using CellGro(CellGenix), and supplemented with GM-CSF (1000 U/ml) and IL-4 (250U/ml) (both PeproTech). The next day, the cells were harvested andtransfected with either PD-L2 siRNA or negative control siRNA. Thetransfection procedure and electroporation parameters were used aspreviously described (13) For electroporation, cells were resuspended ata concentration of 2×106 per 200 ul of OptiMEM medium (Invitrogen).Cells were kept on ice and added with 0.25 nmol of each PD-L2 siRNAduplexes. Subsequently, cells were transferred into a 2 mm kuvette andwere electroporated with a single pulse at 250 Volts for 2 milli secondsusing a BTX 830 square-wave electroporator (Harvard Apparatus, HollistonMass., USA).

Immediately after electroporation, monocytes were transferred toprewarmed CellGro medium containing DC-maturation cocktail: IL-0(1,000U/mL), IL-6 (1,000 U/mL), TNF-α (1,000 U/mL), and PGE2 (1 mg/mL) (allfrom PeproTech). After 48 hours incubation, the transfected matured DCswere used for experimental analysis. PD-L2 surface expression on the DCstransfected with PD-L2 siRNA and negative control siRNA was analyzedusing anti-human PD-L2-PE (BD biosciences). Functionality ofPD-L2-specific T-cell cultures towards transfected autologous DCs wasanalysed using ICS and ELISPOT assay as described above. For ICS, T-cellcultures were stimulated with either PD-L2 siRNA or negative controltransfected DCs for 5 hours with ratio of 1:5. In EliSpot assay T-cellcultures were stimulated with the DCs for 24 hours with ratio of 1:5.Statistical analysis An ELISPOT response was defined, based on theguidelines and recommendations provided by CIP and Moodie et al (5). Thenon-parametric distribution-free resampling (DFR) and more conservativeDFRx2 statistical test were used for a formal comparison betweenantigen-stimulated wells and negative-control wells. The ELISPOT assayswere performed at least in triplicate.

Results

Natural T Cell Reactivity Against PD-L2

The amino acid sequence of the PD-L2 protein was screened with the“SYFPEITHI” database (15) to predict the best HLA-A2 peptide epitopes.The algorithm identified 22 peptides that were top candidates, based onpredictive scores in the range of 22-29. We selected 9 peptides forsynthesis and further study, based on their location in the PD-L2protein. At least part of the peptide had to be located in the signalpeptide or the transmembrane domain. These nine peptides were used withthe IFN-γ ELISPOT in vitro assay to test for the presence of specificT-cell responses in PBMCs from different HLA-A2+ patients with cancer.We detected immune responses against PD-L215 (PD-L2(234-243)), and inparticular, against PD-L201 (PD-L2(4-12)) and PD-L205 (PD-L2(16-25))(FIG. 1).

Next, we utilized both the IFN-γ and TNF-α ELISPOT assays to examine 5selected PBMCs for immune responses against PD-L201 (PD-L2(4-12)) andPD-L205 (PD-L2(16-25)) (FIGS. 2A and 2B). All IFN-γ and TNF-α responseswere statistically significant, according to the DFR test (FIGS. 2A and2B). In addition, the IFN-γ responses and one TNF-α response werestatistically significant according to the DFRx2 rule (FIGS. 2A and 2B).Next, we tested PBMCs from healthy donors for immune responses againstboth PD-L2-derived epitopes with the IFN-γ ELISPOT assay. We detectedstrong immune responses against PD-L205 (PD-L2(16-25)), and weakerresponses against PD-L201 (PD-L2(4-12)) in healthy individuals (FIG.2C). In general, PD-L205 (PD-L2(16-25)) appeared to be the dominantepitope for eliciting immune responses. Next, we tested PBMCs from fourdonors, directly ex vivo (without prior in vitro peptide stimulation),for responses against PD-L205 (PD-L2(16-25)) with the IFN-γ ELISPOTassay (FIG. 2D). The PBMCs from one of these donors showed an ex vivoIFN-γ response that was statistically significant, according to the DFRrule (FIG. 2D).

Finally, to test for spontaneous, PD-L2-specific, CD4+ T-cell responses,we synthesized two longer PD-L2 peptides. One of these, PD-L2long 1(PD-L2(9-29); SLELQLHQI-AALFTVTVPKEL, SEQ ID NO: 11), included thePD-L205 (PD-L2(16-25)) epitope; and the other, PD-L2long2 (PD-L2(1-25);MIFLLLMLSLELQLHQIAALFTVTV, SEQ ID NO: 12), included both the PD-L201(PD-L2(4-12)) and PD-L205 (PD-L2(16-25)) epitopes. We tested PBMCs from11 patients with cancer and 11 healthy donors for the presence of CD4+ Tcell responses against these long peptides with the IFN-γ ELISPOT assay.We detected frequent but moderate responses (FIG. 3A). Next, we isolatedPBMCs from four non-hodgkin lymphoma patients and screened for IFN-γresponses towards PD-L2long2 (PD-L2(1-25)) in an in vitro ELISPOT assay.All four patients showed responses that were statistically significant,according to the DFR rule (FIGS. 3B and 3C). Tumor infiltratingT-lymphocytes from two melanoma patients also elicited IFN-γ CD4+ T-cellresponses towards PD-L2long2 (PD-L2(1-25)) measured by usingintracellular cytokine staining (FIG. 3D).

PD-L2-Specific T Cells were Effector Cells Releasing Pro-InflammatoryCytokines

To characterize the immune response elicited by PD-L2, we isolatedPD-L205-specific T cells. Briefly, PBMCs isolated from a patient withmelanoma (AA26) were expanded in vitro. Then, PBMCs were stimulated withirradiated autologous DCs that had been pulsed with PD-L205. Specific Tcells were isolated either by staining with anti-CD137 antibody (PD-L2 Tcell culture-A) or with the TNF-α enrichment method (PD-L2 T cellculture-B). These specific T cells were cultured and expanded with highdose IL-2, then analyzed for specificity against PD-L205 (PD-L2(16-25))with intracellular cytokine staining (FIGS. 4A and 4B), ELISPOT (FIG.4C) and cytotoxicity assays (FIG. 4D). We detected TNF-α release inresponse to PD-L205(PD-L2(16-25)) in about 4.5% and 1% of CD4+ and CD8+T cells, respectively, from PD-L2 T cell culture-A; and about 7% and 2%of CD4+ and CD8+ T cells, respectively, from PD-L2 T cell culture-B(FIG. 4A). Additionally, we detected TNF-α release in response toautologous DCs in around 3% and 2.8% of CD4+ T cells from PD-L2 T cellculture-A and -B respectively (FIG. 4B). Furthermore, IFN-Y and TNF-α Tcell responses were observed towards PD-L205 (PD-L2(16-25)) peptide andautologous DCs in both PD-L2 specific cultures (FIG. 4C). Both expandedcultures also recognized and lysed T2 cells that had been pulsed withPDL205 (PD-L2(16-25)) in conventional 51chromium-release assays, butthey did not recognize T2 cells pulsed with an irrelevant HIV peptide(HIV-1 pol476-484) (FIG. 4D).

PD-L2 Dependent Reactivity in Response to PD-L2 Expressing DCs

PD-L2 can be induced in immune cells. Thus, as the next and very moreimportant step, we addressed the question whether PD-L2-expressing DCswould also be recognized by PD-L2-reactive T cells. To test this notion,we generated autologous DCs; and transfected these with PD-L2 siRNA. Wefirst examined PD-L2 protein expression on the matured siRNA transfectedDCs (FIG. 5A). PD-L2 expression was down regulated on DCs transfectedwith PD-L2 siRNA compared to a negative control siRNA, 48 hours afterelectroporation (FIG. 5A). Next, we examined reactivity of PD-L2 T-cellcultures in response to the transfected DCs using intracellular cytokinestaining (FIG. 5B) and ELISPOT assay (FIG. 5C). Both PD-L2 T cellcultures show reduced CD4+ and CD8+ T-cell cytokine response towards DCstransfected with PD-L2 siRNA compared to a negative control siRNA (FIG.5B). Similarly in both cultures, the number of TNF-α releasing T cellswere significantly reduced in response to DCs transfected with PD-L2siRNA compared to a negative control siRNA in an TNF-α ELISPOT assay(FIG. 5C). These results confirmed that the reactivity of target cellswere dependent on PD-L2 expression.

PD-L1-Specific and PD-L2-Specific T Cells Did not Cross-React

The dominant PD-L2 epitope in eliciting a T cell response was PD-L205(PD-L2(16-25); QIAALFTVTV, SEQ ID NO: 4). Interestingly, we previouslydescribed another HLA-A2 restricted epitope in PD-L1 (termed PD-L101(PDL1(15-23); LLNAFTVTV, SEQ ID NO: 27) (1), (2), (6), which elicited astrong T cell response. These two dominant T-cell epitopes were locatedin almost the same position in the PD-L1 and PD-L2 proteins (FIG. 6A).Moreover, these two dominant epitopes shared five amino acids (FTVTV;SEQ ID NO 34), due to sequence similarities between PD-L1 and PD-L2(FIG. 6A). Thus, we tested for a potential cross reactivity betweenPD-L205 (PD-L2(16-25))-specific and

PD-L101 (PDL1(15-23))-Specific T Cells.

First, we isolated PBMCs from patients with cancer that responded toPD-L205 (PD-L2(16-25)). When we examined whether these PBMCs showedspontaneous T-cell responses against PD-L101 (PDL1(15-23)), we did notdetect any immune response with the IFN-γ ELISPOT test (FIG. 6B). Next,we examined the potential cross-reactivity of a PD-L101-specific T-cellculture (1). We used standard 51Cr release assays with TAP-deficient T2cells as target cells. The target cells were loaded with PD-L101(PDL1(15-23)), PD-L205 (PD-L2(16-25)), or an irrelevant control peptidefrom HIV (HIV-1 pol476-484). FIG. 6C illustrates that thePD-L101-specific T cells only lysed T2-cells pulsed with PD-L101(PDL1(15-23)), and no cytotoxicity was observed against T2-cells pulsedwith either PD-L205 (PD-L2(16-25)), or the irrelevant HIV peptide. Next,we performed an intracellular cytokine staining assay to analyzecytokine release (IFN-γ and TNF-α) from PD-L101-specific CD8+ T cells,in response to PD-L101 (PDL1(15-23)), PD-L205 (PD-L2(16-25)), or thecontrol HIV peptide (FIG. 5C). Again, we found that PD-L101-specific Tcells released cytokines only in response to PD-L101 (PDL1(15-23)) andnot in response to PD-L205 (PD-L2(16-25)) or the irrelevant HIV peptide(FIG. 6D).

Finally, we examined whether PD-L205-reactive T cells could specificallyrecognize PD-L205 (PD-L2(16-25)), but not PD-L101 (PDL1(15-23)). Weexamined the two established PD-L205-reactive T-cell cultures with thestandard 51Cr release assays, with TAP-deficient T2 cells as targetcells. The target cells were loaded with PD-L205 (PD-L2(16-25)), PD-L101(PDL1(15-23)), or the control HIV peptide (HIV-1 pol476-484). ThePD-L205-specific T cells could indeed recognize T2 cells pulsed withPD-L205 (PD-L2(16-25)), but they did not kill T2 cells pulsed withPD-L101 (PDL1(15-23)), or with the control HIV peptide (FIG. 6E).

DISCUSSION

In the present study, PD-L2 was examined as a target for specific Tcells, and it was determined that PD-L2-specific T cells arespontaneously present in patients with different cancers including NHL.In general, the strongest responses were elicited by the peptide,PD-L205 (SEQ ID NO 4). Surprisingly, we observed both CD8+ and CD4+ Tcells that specifically recognized the minimal epitope inPD-L205(PD-L2(16-25)), selected for its HLA-A2 peptide binding motif.Interestingly, the PD-L205(PD-L2(16-25)) epitope was similar to the mainHLA-A2 restricted epitope that was identified previously in PD-L1.Importantly, PD-L1- and PD-L2-specific T cells did not cross react;therefore, they should be considered different T-cell antigens. Theresults further showed that PD-L2-specific T cells specificallyrecognize PD-L2+ target cells. Hence, PD-L2-specific T cells recognizetarget cells in response to their PD-L2 expression levels. We thereforesuggest that inducing/boosting T-cell responses against PD-L2 (e.g., byvaccination) represents an attractive strategy for treating hematologicmalignancies, including NHL. These findings justify clinical testing toevaluate the efficacy of a PD-L2-based vaccination. Consequently,applicant is currently initiating the first PD-L2 vaccine study inhumans at Herlev Hospital (Denmark). In that study, the long PD-L2epitope described in this study will be administered to high-riskpatients with NHL that are in remission after second-line chemotherapy.This approach represents a major difference from employing monoclonalantibodies to target the PD1/PDL pathway. Indeed, in addition toreducing the direct immuno-regulatory effects of PD-L2, thesePD-L2-specific T cells might also inhibit other routes of immunesuppression that are mediated by PD-L2+ target cells (7).

It was demonstrated that PD-L2-specific T-cells released both IFN-γ andTNF-α. Notably, the investigation found PD-L2 specific T-cell responsesdirectly ex vivo underlining the immunogenicity of this antigen (8).Accordingly, PD-L2-based vaccines should be viewed as complementary,rather than competitive, to other forms of immunotherapy. For example,combining a PD-L2 vaccination with a checkpoint blocker is believed tobe an effective therapy. A checkpoint blockade could boostvaccine-activated PD-L2-specific T cells by preventing their inhibitionat the tumor site. Likewise, the vaccine-induced upregulation ofcheckpoint molecules, due to the release of pro-inflammatory cytokines,would also be blocked by the checkpoint inhibitors. Finally, it wasfound that T cells spontaneously reacted to PD-L2-derived epitopeslocated in the signal peptide region of PD-L2. Hence, the PD-L2 epitopesrecognized by T cells are therefore different than any epitoperecognized by anti-PDL2 blocking antibodies. In general, cancer vaccinesrepresent a way to eliminate minimal residual disease without inducingsignificant toxicity and secondary malignancies. However, to date, theyhave largely failed to demonstrate a significant improvement in patientoutcome (9). This failure probably reflects the ability of malignantcells to suppress the function of the induced immune cells. The additionof PD-L2 epitopes to current cancer vaccine strategies is likely to behighly beneficial, and it would be easy to implement. Furthermore,unlike tumor cells, stromal cell types in the tumor microenvironment aregenetically stable, and thus, they represent attractive therapeutictargets with reduced risk of resistance and tumor recurrence.

In conclusion, this present study described naturally-occurring,PD-L2-specific T cells in patients with cancer. PD-L2 may thus serve asa highly accessible target for immunotherapeutic strategies.

Sequences Used in the Specification:

Extended PDL2(1-273): (SEQ ID NO. 1)MIFLLLMLSLELQLHQIAALFTVTVPKELYIIEHGSNVTLECNFDTGS-HVNLGAITASLQKVENDTSPHRERATLLEEQLPLGKASFHIPQVQVRD-EGQYQCIIIYGVAWDYKYLTLKVKASYRKINTHILKVPETDEVELTCQ-ATGYPLAEVSWPNVSVPANTSHSRTPEGLYQVTSVLRLKPPPGRNFSC-VFWNTHVRELTLASIDLQSQMEPRTHPTWLLHIFIPFCIIAFIFIATV-IALRKQLCQKLYSSKDTTKRPVTTTKREVNSAI PDL2(4-12): (SEQ ID NO. 2) LLLMLSLELPDL2(231-240): (SEQ ID NO. 3) IIAFIFIATV  PDL2(16-25): (SEQ ID NO. 4)QIAALFTVTV PDL2(6-14): (SEQ ID NO. 5) LMLSLELQL PDL2(9-17):(SEQ ID NO. 6) SLELQLHQI PDL2(234-243): (SEQ ID NO. 7) FIFIATVIALPDL2(11-20): (SEQ ID NO. 8) ELQLHQIAAL PDL2(1-10): (SEQ ID NO. 9)MIFLLLMLSL PDL2(226-235): (SEQ ID NO. 10) FIPFCIIAFI PDL2(9-29)(SEQ ID NO. 11) SLELQLHQIAALFTVTVPKEL PDL2(1-25) (SEQ ID NO. 12)MIFLLLMLSLELQLHQIAALFTVTV PDL2(125-143) (SEQ ID NO. 13) KINTHILKVPDL2(51-59) (SEQ ID NO. 14) NLGAITASL PDL2(54-62) (SEQ ID NO. 15)AITASLQKV PDL2(74-82) (SEQ ID NO. 16) TLLEEQLPL PDL2(30-38)(SEQ ID NO. 17) YIIEHGSNV PDL2(145-153) (SEQ ID NO. 18) ATGYPLAEVPDL2(172-180) (SEQ ID NO. 19) GLYQVTSVL PDL2(168-176) (SEQ ID NO. 20)RTPEGLYQV PDL2(242-251) (SEQ ID NO. 21) ALRKQLCQKL PDL2(31-40)(SEQ ID NO. 22) IIEHGSNVTL PDL2(130-139) (SEQ ID NO. 23) ILKVPETDEVPDL2(149-158) (SEQ ID NO. 24) PLAEVSWPNV PDL2(4-25) (SEQ ID NO: 25)LLLMLSLELQLHQIAALFTVTV HIV-1 pol476-484 (SEQ ID NO: 26) ILKEPVHGVPDL1(15-23) (SEQ ID NO: 27) LLNAFTVTV PD-L2 siRNA duplexes(SEQ ID NO 28) 5′-CAUCCUAAAGGUUCCAGAAtt-3′ (SEQ ID NO 29)5′-UUCUGGAACCUUUAGGAUGtg 3′ (SEQ ID NO 30) 5′-CCUAAGGAACUGUACAUAAtt-3′(SEQ ID NO 31) 5′-UUAUGUACAGUUCCUUAGGga 3′ (SEQ ID NO 32)5′-GAAAACAACUCUGUCAAAAtt-3′ (SEQ ID NO 33) 5′-UUUUGACAGAGUUGUUUUCtt 3′PDL1 and PDL2 epitopes shared five amino acids (SEQ ID NO 34) FTVTV

REFERENCES

-   1. Munir S, Andersen G H, Met O, Donia M, Frosig T M, Larsen S K et    al. HLA-restricted cytotoxic T cells that are specific for the    immune checkpoint ligand PD-L1 occur with high frequency in cancer    patients. Cancer Research 2013; 73: 1674-1776.-   2. Munir S, Andersen G H, Woetmann A, Odum N, Becker J C, Andersen    M H. Cutaneous T cell lymphoma cells are targets for immune    checkpoint ligand PD-L1-specific, cytotoxic T cells. Leukemia 2013;    27: 2251-2253.-   3. Larsen S K, Munir S, Woetmann A, Froesig T M, Odum N, Svane I M    et al. Functional characterization of Foxp3-specific spontaneous    immune responses. Leukemia 2013; 27: 2332-2340.-   4. Martinenaite E, Ahmad S M, Hansen M, Met O, Westergaard M W,    Larsen S K et al. CCL22-specific T cells: Modulating the    Immunosuppressive Tumor Microenvironment. Onco-immunology 2016; 5:    e1238541-   5. Moodie Z, Price L, Janetzki S, Britten C M. Response    determination criteria for ELISPOT: toward a standard that can be    applied across laboratories. Methods Mol Biol 2012; 792: 185-196.-   6. Ahmad S M, Larsen S K, Svane I M, Andersen M H. Harnessing    PD-L1-specific cytotoxic T cells for anti-leukemia immunotherapy to    defeat mechanisms of immune escape mediated by the PD-1 pathway.    Leukemia 2014; 28: 236-238.-   7. Andersen M H. Immune Regulation by Self-Recognition: Novel    Possibilities for Anti-cancer Immunotherapy. J Natl Cancer Inst    2015; 107: 154-   8. Keilholz U, Weber J, Finke J H, Gabrilovich D I, Kast W M, Disis    M L et al. Immuno-logic monitoring of cancer vaccine therapy:    results of a workshop sponsored by the Society for Biological    Therapy. J Immunother 2002; 25: 97-138.-   9. Rhee F. Idiotype vaccination strategies in myeloma: how to    overcome a dysfunctional immune system. Clin Cancer Res 2007; 13:    1353-1355.

I claim:
 1. A method of treating cancer in a patient, wherein the canceris characterized by the expression of programmed death ligand 2 (PDL2),the method comprising administering to the patient an effective amountof a peptide fragment of a human PDL2 protein of SEQ ID NO: 1, whichfragment consists of a consecutive sequence of up to 60 amino acids ofSEQ ID NO: 1 and which comprises an amino acid sequence selected fromSEQ ID NOs 11, 2, 4 and 12; or a pharmaceutically acceptable saltthereof; or a nucleic acid encoding said peptide fragment; or a vectorcomprising a nucleic acid encoding said peptide fragment.
 2. The methodof claim 1 wherein: (a) the peptide fragment comprises a consecutivesequence in the range from 10 to 17 amino acids, 20 to 30 amino acids;30 to 40 amino acids, or from 40 to 50 amino acids; and/or (b) thepeptide fragment does not comprise amino acid 1-3 of SEQ ID NO 1; and/or(c) the peptide fragment is up to 9, 10, 11, 12, 13, 14, 15, 16, 17, 18,19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, or 30 amino acids in length;and/or (d) the peptide fragment is an isolated, immunogenic peptidefragment.
 3. The method of claim 1, wherein the peptide fragmentcomprises SEQ ID NO
 11. 4. The method of claim 1, wherein theconsecutive sequence comprises SEQ ID NO
 4. 5. The method of claim 1,wherein the method further comprises the simultaneous or sequentialadministration of an additional cancer therapy.
 6. The method of claim5, wherein the additional cancer therapy is a cytokine therapy, a T-celltherapy, a Natural Killer (NK) therapy, an immune system checkpointinhibitor, a chemotherapy, a radiotherapy, an immunostimulatingsubstance, a gene therapy, an antibody or dendritic cells.
 7. The methodof claim 5, wherein the additional cancer therapy is selected from oneor more of Actimide, Azacitidine, Azathioprine, Bleomycin, Carboplatin,Capecitabine, Cisplatin, Chlorambucil, Cyclophosphamide, Cytarabine,Daunorubicin, Docetaxel, Doxifluridine, Doxorubicin, Epirubicin,Etoposide, Fludarabine, Fluorouracil, Gemcitabine, Hydroxyurea,Idarubicin, Irinotecan, Lenalidomide, Leucovorin, Mechlorethamine,Melphalan, Mercaptopurine, Methotrexate, Mitoxantrone, Nivolumab,Oxaliplatin, Paclitaxel, Pembrolizumab, Pemetrexed, Temozolomide,Teniposide, Thioguanine, Valrubicin, Vinblastine, Vincristine, Vindesineand Vinorelbine.
 8. The method of claim 1 wherein the cancer is selectedfrom the group consisting of melanoma, renal cell carcinoma, non-hodgkinlymphoma, and ovarian cancer.